Deisenhammer Eberhard A, Lechner-Schoner Theresia, Kemmler Georg, Ober Alexander, Braidt Eva, Hinterhuber Hartmann
Department of General Psychiatry, Innsbruck Medical University, Austria.
Alcohol Clin Exp Res. 2006 Mar;30(3):460-5. doi: 10.1111/j.1530-0277.2006.00050.x.
Alcohol dependence is a major risk factor for suicidal behavior. Although a number of risk factors have been suggested there is still no well-defined risk profile for attempted suicide in alcoholic patients. Alterations of serum lipids have been associated with completed as well as attempted suicide and with suicidal ideation. This study investigated potential demographic and clinical risk factors for attempted suicide in alcohol-dependent patients taking serum lipids additionally into consideration.
One-hundred ten alcohol-dependent patients who were admitted to a psychiatric university hospital department for inpatient treatment were grouped according to whether or not they had a lifetime history of attempted suicide. Attempters versus nonattempters as well as attempters who used a violent versus a nonviolent suicide method were compared.
Patients who had attempted suicide at least once in their life differed significantly from those who had no history of suicide attempts. Univariate analyses showed that they were younger (41.7 years vs 46.8 years; p = 0.003), were more often smokers (97% vs 77%; p = 0.011), had more frequently coabused benzodiazepines (54% vs 17%; p = 0.002), and scored currently higher on the Montgomery and Asberg Depression Rating Scale (MADRS) global scale (26.3 vs 20.2; p = 0.005) as well as the "suicidal thoughts" item (1.8 vs 0.6; p = 0.001). Additionally, they had higher serum triglyceride levels (178.9 vs 127.5; p = 0.039). A logistic regression analysis left coabuse of benzodiazepines [odds ratio (OR), 5.26; p = 0.001], younger age (OR per year increase of age, 0.91; p = 0.006), and current MADRS item 10 ("suicidal thoughts") score (OR per point increase in MADRS item 10 score, 1.43; p = 0.019) as significant factors. Suicide attempters who had used a violent method were significantly more often male (82% vs 44%; p = 0.035), were younger (38.2% vs 45.1 years; p = 0.008), and had less frequently coabused tranquilizers (35% vs 78%; p = 0.018) than nonviolent attempters.
These findings contribute to the development of a more specific profile of alcohol-dependent individuals at risk for suicidal behavior. Further research is required to determine the role of serum triglycerides for suicidal behavior in patients with alcohol dependence.
酒精依赖是自杀行为的主要危险因素。尽管已提出多种危险因素，但酒精依赖患者自杀未遂的风险特征仍未明确界定。血清脂质改变与自杀死亡及自杀未遂以及自杀观念均有关联。本研究额外考虑血清脂质情况，调查了酒精依赖患者自杀未遂的潜在人口统计学和临床危险因素。
110名入住大学精神病医院科室接受住院治疗的酒精依赖患者，根据其是否有自杀未遂史进行分组。比较了自杀未遂者与未未遂者，以及使用暴力自杀方法与非暴力自杀方法的自杀未遂者。
有过至少一次自杀未遂经历的患者与无自杀未遂史的患者有显著差异。单因素分析显示，他们更年轻（41.7岁对46.8岁；p = 0.003），吸烟更频繁（97%对77%；p = 0.011），同时滥用苯二氮䓬类药物的情况更常见（54%对17%；p = 0.002），当前在蒙哥马利-阿斯伯格抑郁评定量表（MADRS）总分上得分更高（26.3对20.2；p = 0.005）以及在“自杀想法”项目上得分更高（1.8对0.6；p = 0.001）。此外，他们的血清甘油三酯水平更高（178.9对127.5；p = 0.039）。逻辑回归分析显示，同时滥用苯二氮䓬类药物（比值比[OR]，5.26；p = 0.001）、更年轻（年龄每增加一岁的OR，0.91；p = 0.006）以及当前MADRS第10项（“自杀想法”）得分（MADRS第10项得分每增加一分的OR，1.43；p = 0.019）是显著因素。使用暴力自杀方法的自杀未遂者比非暴力自杀未遂者男性比例显著更高（82%对44%；p = 0.035），更年轻（38.2岁对45.1岁；p = 0.008），同时滥用镇静剂的情况更不常见（35%对78%；p = 0.018）。
这些发现有助于制定更具体的酒精依赖个体自杀行为风险特征。需要进一步研究以确定血清甘油三酯在酒精依赖患者自杀行为中的作用。
